Maybe This Christmas…?

CHAPTER THREE

Christmas: ten years ago

‘IT’S a big ask, Gemma. I know that.’

The PICU consultant was dressed in a dinner suit, complete with a black velvet bow-tie. He was running late for a Christmas Eve function. Gemma already felt guilty for calling him in but she’d had no choice, had she? Her senior registrar and the consultant on duty were caught up dealing with a six-month-old baby in heart failure and a new admission with a severe asthma attack.

The deterioration in five-year-old Jessica’s condition had been inevitable but the decision to withdraw treatment and end the child’s suffering had certainly not been one a junior doctor could make.

‘You don’t have to do it immediately,’ her consultant continued. ‘Any time tonight is all right. Wait until you’ve got the support you need. I’m sorry… but I really can’t stay. This function is a huge deal for my daughter. She’s leading in the carol choir doing a solo of “Once in Royal David’s City” and if I don’t make it my name will be mud and tomorrow’s…’

‘Christmas.’ Gemma nodded. She managed a smile. ‘Family time that shouldn’t be spoiled if it can be helped.’

‘You’ve got it.’ The older man sighed. ‘If there was any chance of improving the outcome by heroic measures right now I’d stay, of course. But we’d only be prolonging the inevitable.’

‘I know.’

They’d all known that almost as soon as Jessica had been admitted. The battle against cancer had been going on for half the little girl’s life and she’d seemed to be in remission but any infection in someone with a compromised immune system was potentially catastrophic.

Over the last few days they had been fighting multiorgan failure and the decision that had been made over the last hour had been much bigger than whether or not to begin dialysis to cope with her kidneys shutting down.

Gemma had to swallow the lump in her throat. ‘I just don’t understand why her mother won’t come back in.’

‘She’s a foster-mother, Gemma,’ he reminded her. ‘She loves Jessica dearly but she’s got six other children at home and… it’s Christmas Eve. She was in here for most of the day and she’s said her goodbyes. It’s not as if Jessica’s going to wake up. You’ll take her off the life support and she’ll just stop breathing. It probably won’t take very long.’ The consultant glanced at his watch as he reached for a pen. ‘I’ll write it up. As I said, I know it’s a big ask. No one will blame you if you’re not up for it but I know how much time you’ve spent with her since her admission and I thought…’

Gemma took a shaky inward breath. Yes, she’d spent a lot of time with Jessica. Too much, probably, especially before she’d been sedated and put on life support. Certainly enough time to have fallen in love with the child and, if the closest thing to a mother she had couldn’t be here at the end then someone who loved her was surely next best.

‘I can do it,’ she whispered. ‘But… not just yet.’

‘Take all the time you need.’ The consultant signed his name on the order and turned to leave. He paused to offer Gemma a sympathetic smile. ‘You’re one of the best junior doctors I’ve ever had the pleasure of working with,’ he said, ‘but this isn’t a time for being brave and trying to cope on your own. Every person who works in here will understand how tough this is. Take your pick but find someone to lean on, OK?’

Gemma couldn’t speak. She could only nod.

It was the way she was standing that caught his attention.

She looked as though she was gathering resolution to dive into a pool of icy water. Or knock on a door when she knew that somebody she really didn’t want to see was going to answer the summons. What was going on in that closed room of the PICU? Andrew Baxter had to focus to tune back into what his registrar was saying.

‘So we’ll keep up the inotropic support overnight.

Keep an eye on all the parameters, especially urine output. If it hasn’t picked up by morning we’ll be looking at some more invasive treatment for the heart failure.’ The registrar yawned. ‘Call me if anything changes but, in the meantime, I’m going to get my head down for a bit.’ His smile was cheerful. ‘You get to stay up and mind the shop. One of the perks of being the new kid on the block.’

‘I don’t mind.’ Andy returned the smile, aware of the woman still standing as still as a statue outside that room. He hesitated only briefly after his companion left.

‘Hey.’ His greeting was quiet. ‘Do you… um… need any help?’

She looked up at him and Andy was struck by two things. The first, and most obvious, was the level of distress in her eyes. The second was the eyes themselves. He’d never seen anything like them. Flecks of gold in the rich hazel depths and an extraordinary rim of the same gold around the edges of the irises. He couldn’t help holding the eye contact for longer than he should with someone he’d never met but she didn’t seem to mind. One side of her mouth curved upwards in a wry smile.

‘Got a bit of courage to spare?’

Andy could feel himself standing a little bit taller. Feeling more confident than he knew he had a right to. ‘You bet,’ he said. ‘How much would you like?’

‘Buckets,’ she said, a tiny wobble in her voice. ‘Have you ever had to turn off someone’s life support?’

Andy blew out a slow breath. ‘Hardly. I’m a baby doctor. I started in the August intake and I’ve only just begun my second rotation.’

‘Me, too.’

‘And your team has left you to deal with this on your own?’ Andy was horrified.

She shook her head. ‘I get to choose a support person. My registrar is busy with the other consultant on the asthma case that came in a little while ago and the other registrar on duty is in with a baby. I think it’s a cardiac case.’

Andy nodded. ‘It is. I’m on a cardiology run. Six-month-old that’s come in with heart failure. I’ll probably be here all night, monitoring him. At the moment they’re trying to decide whether to take him up to the cath lab for a procedure. I got sent out to check availability.’

‘Sounds full on.’

‘It won’t be. If we’re not going to the cath lab immediately I’ll be floating around here pretty much for hours.’ Andy tried to sound casual but her words were echoing in his head. She was allowed to choose a support person. The desire to be that person came from nowhere but it was disturbingly strong. It was emotional support she needed, not medical expertise, and surely he would understand how she would be feeling better than anyone else around here. They were both baby doctors and he knew how nervous he’d be in her position. How hard something like this would be.

Andy gave her an encouraging smile. ‘I could be your support person.’

Gemma could feel her eyes widening.

She didn’t even know this guy’s name and he was being so… nice.

Genuine, too. He had dark brown eyes that radiated warmth. And understanding. Well, that made sense. He was at the same stage of his career as she was with hers and he’d never been in this position. Maybe, like her, he still hadn’t even seen someone actually die. Gemma could be quite sure that anyone else here in the PICU had seen it before. It didn’t mean that they wouldn’t be able to support her but they might have forgotten just how scary it was that first time. Not knowing how it might hit you. How unprofessional you might end up looking…

Gemma didn’t want to look unprofessional. Not in front of people who were more senior to herself and might judge her for it.

Kind eyes was smiling at her. ‘Sorry—I haven’t even introduced myself. Andrew Baxter. Andy…’ He held out his hand.

Gemma automatically took the hand. It was warm and big and gave hers a friendly squeeze rather than a formal shake. He let go almost immediately but she could still feel the warmth. And the strength.

‘I’m Gemma,’ she told him.

‘Hello, Gemma.’ Andy’s smile faded and he looked suddenly sombre. ‘Would you like me to check with my consultant about whether it’s OK for me to hang out with you for a while?’

Gemma found herself nodding. ‘I’ll ask whether someone more senior has to be there. But there’s no rush,’ she added hurriedly. ‘I wanted to just sit with Jessie for a bit first.’

He held her gaze for a moment, a question in his eyes. And then he nodded as though he approved of the plan.

‘I’ll come and find you,’ he promised.

It was remarkably private in one of these areas of the PICU when the curtains were drawn over the big windows and the door was closed.

Remarkably quiet, too, with just the gentle hiss of the ventilator and muted beeping from the bank of monitoring equipment.

The nurse had given Gemma a concerned look before she’d left her alone in there with Jessica.

‘Are you sure you don’t want me to stay?’